Preeclampsia: “watchful waiting” does not increase odds of a child having ASD

While women who develop preeclampsia during pregnancy have an increased likelihood of having a child with autism spectrum disorder (ASD), researchers in California report that “expectant management” of pre-eclampsia does not increase these odds.

Pre-eclampsia, a condition that affects 2% to 8% of pregnancies, typically develops after 20 weeks of pregnancy. Signs and symptoms include high blood pressure, excess protein in the urine (a sign of kidney damage), increased liver enzymes (a sign of liver damage), headaches, nausea, and excess swelling. Preeclampsia can be very dangerous for a mother and baby, and delivery of the baby generally reverses the condition. However, doctors frequently opt for “expectant management”—that is, monitoring the condition and controlling it with medications—rather than immediately delivering a baby, in order to prevent the baby from being significantly premature.

In their new study, Sarah Carter and colleagues analyzed data from a clinical cohort including more than 360,000 mother-child pairs. The researchers examined the health records of the women during pregnancy and determined which children had received an ASD diagnosis by five years of age.

The researchers found an association between preeclampsia and an elevated likelihood of autism in children, and say that the earlier preeclampsia began, the stronger this association was. However, they say, the number of days between preeclampsia onset and delivery was not associated with the odds of a child developing ASD. This indicates, they say, that compared to immediately delivering a baby, expectant management does not increase the odds of a child receiving an ASD diagnosis.

Citations

“Preeclampsia onset, days to delivery, and autism spectrum disorders in offspring: clinical birth cohort study,” Sarah Carter, Jane C. Lin, Ting Chow, Mayra P. Martinez, Chunyuan Qiu, R. Klara Feldman, Rob McConnell, and Anny H. Xiang, JMIR Public Health and Surveillance, April 17, 2024 (free online). Address: Anny H. Xiang, Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S Los Robles Ave, Pasadena, CA, 91101, [email protected].